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Locum agencies are creaming off up to half the fees NHS hospitals pay them to supply last-minute staff, a Telegraph investigation has found.

Staff at one of the biggest recruiters of temporary healthcare workers boast that they are each earning hundreds of thousands of pounds a year in commission – largely from the health service. Individual hospitals are being charged up to 20 per cent more than other organisations for the same nurses, as the agencies exploit NHS short staffing – and a lack of transparency in the system – to make vast profits.

Jeremy Hunt, the Health Secretary, last night said it was unacceptable for agencies to be making “big profits” from the NHS and promised action.

However, until now it has been unclear how much of the fees charged to hospitals go to the staff and how much is kept by the agencies. The Daily Telegraph has established that in some cases, it is as much as 49 per cent.

This means that if an NHS hospital pays £50 an hour for an agency nurse – the person actually working at the hospital will receive only about half of the fee, while the agency earns hundreds of pounds in commission for each shift.

Mr Hunt said: “This investigation by the Telegraph shows how some staffing agencies seek to turn big profits at the expense of our NHS and hardworking taxpayers. It’s further evidence of exactly why we have introduced a tough new cap on what hospitals can pay for agency staff.The cap will be ratcheted down over the next few months to reduce the margins rip-off agencies are able to generate.”

Sarah Wollaston, the chairman of the health select committee, said the Government should publish details of the fees taken by agencies as transparency would “drive changes to behaviour”.

Earlier this year, a whistleblower approached the Telegraph with concerns about Capita-owned Medicare and Team24 in their dealings with NHS hospitals and nurses. Both provide nurses to NHS, although Medicare specialises in covering last-minute shifts.

A Telegraph reporter later obtained a job as an out-of-hours locum nurse recruiter working at the offices shared by the companies in Reigate, Surrey.

The Medicare website

In October, Medicare was generally charging the NHS between £43 and £69 per hour for a general nurse and up to £76 for an A&E nurse. Up to 49 per cent of the fee was kept by the agency. Some other agencies charge the NHS as little as 11 per cent in fees.

Capita said it complied with NHS regulations and operated to high professional standards. It said that “on average” nurses received more than 50 per cent of fees charged. Rates were affected by factors including the distances nurses had to travel.